Author + information
- Received August 26, 1991
- Revision received December 19, 1991
- Accepted January 4, 1992
- Published online July 1, 1992.
- Olusola Odemuyiwa, MD∗,
- Marek Malik, MD, PhD, FACC,
- Jan Poloniecki, DPhil,
- Thomas Farrell, MRCP,
- Piotr Kulakowski, MD,
- Teri Millane, MRCP,
- Anne Staunton, RN and
- John Camm, MD, FACC
- ↵∗Address for correspondence: Olusola Odemuyiwa, MD, Department of Cardiological Sciences, St. George's Hospital Medical School, Cranmer Terrace, London SW17 0RE, England.
The predictive characteristics of spectral temporal analysis and time domain analysis of the signal-averaged electrocardiogram (ECG) for postinfarction arrhythmic events were compared in 257 patients. During a 6-month follow-up period, 7 patients (2.7%) died suddenly and 9 (3.5%) developed spontaneous sustained ventricular tachycardia.
The mean numeric values of the standard time domain signal-averaged ECG variables in patients without arrhythmic events differed significantly from those in patients with arrhythmic events. The mean values of the spectral temporal signal-averaged ECG variables did not differ between the two patient groups. A strategy requiring positively in any two time domain signal-averaged ECG variables provided the optimal receiver operating characteristic curves for predicting arrhythmic events. With spectral temporal analysis, a strategy using the Hanning window and diagnosing a positive signal-averaged ECG when two variables were abnormal provided the optimal curve for predicting arrhythmic events.
Receiver operating characteristic curves showed that over a wide range of sensitivity, time domain variables had higher specificity for predicting arrhythmic events than did spectral temporal variables. Time domain analysis also provided significantly fewer false positive results than did spectral temporal analysis up to sensitivity values of 70%.
It is concluded that time domain analysis of the signal-averaged ECG is superior to spectral temporal analysis for predicting arrhythmic events after myocardial infarction.
☆ The study was supported in part by the British Heart Foundation, London.
- Received August 26, 1991.
- Revision received December 19, 1991.
- Accepted January 4, 1992.